Tired during second trimester

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Fatigue During Pregnancy

Fatigue is a common symptom during pregnancy. Some women may feel exhausted throughout their pregnancy, while some may hardly feel tired at all. Although experience with fatigue tends to vary, most women will feel more tired than usual during their pregnancy. Fatigue during pregnancy is most common during the first trimester. It tends to go away during the second trimester, but will usually return in the third trimester.

Fatigue During Pregnancy First Trimester

During early pregnancy, hormonal changes are likely the cause of fatigue. Your body is producing more blood to carry nutrients to your growing baby. Your blood sugar levels and blood pressure are also lower. Hormones especially increased progesterone levels, are responsible for making you sleepy. In addition to the physical changes occurring in your body, emotional changes can contribute to decreased energy.

Whether the pregnancy is planned or unplanned, you may experience anxiety about motherhood, worry about the baby’s health, or even experience conflicting feelings about your pregnancy. It is important to understand that your emotions do play a part in how you feel physically, and all of these things are a natural and normal part of pregnancy.

Fatigue During Pregnancy Second Trimester

During your second trimester, there is a good chance your energy level will increase and you will start to feel more like your old self. Many women take advantage of this time during the pregnancy to accomplish important tasks, as energy levels will likely decrease again in the third trimester. This is often called “The Happy Trimester.” Now don’t be alarmed if during this trimester you still experience fatigue. More than likely it will be less obvious, but unfortunately, fatigue during pregnancy is still possible during the second trimester.

Fatigue During Pregnancy Third Trimester

In late pregnancy, you will most likely begin to feel tired again. At this point you will be carrying extra weight from the baby, maybe having trouble sleeping, and dealing with frequent urination more often. The following are a list of ways to cope with the fatigue you may be experiencing.

Coping Steps for Fatigue During Pregnancy

  • Rest– Make sure you allow yourself to get extra bed rest during the times you feel fatigued. This can be accomplished by going to bed earlier or taking a nap during the day, if possible. Avoiding fluids several hours before bed is also a good way to cut down on the number of times you have to get up at night to use the bathroom.
  • Adjust Schedule – If your current commitments or activities prove to be too draining during pregnancy, you may have to temporarily adjust your schedule to be less busy. This can include cutting back your hours at work, if possible, or asking friends and family to assist you with housework/errands.
  • Eat a Balanced Diet– Eating nutritious meals will go a long way toward supporting your energy levels. Make sure you get enough iron, protein, and calories. Fatigue can become worse if you are not getting the proper nutrients. Also, you will need to ensure you stay hydrated during your pregnancy.
  • Moderate Exercise – Although you may feel like you do not have the energy to exercise, if you incorporate moderate activity, such as a 30-minute walk, this will actually make you feel more energized. Exercise is beneficial in pregnancy unless your healthcare provider has advised otherwise.

Last updated: October 15, 2019 at 19:52 pm

Compiled using information from the following sources:

Roger W. Harms, M.D., E.-I.-C. Mayo Clinic: Guide to a healthy pregnancy. USA: American Academy of Pediatrics.

Exhaustion During Pregnancy

I’m so tired now that I’m pregnant. Is this normal?

It’s normal to feel absolutely dog-tired during pregnancy. In fact, most women find they need a great deal more sleep while pregnant, especially during the first and last trimesters. You may find your bedtime creeping earlier and earlier, and at the same time you may be hitting your snooze button more regularly. The good news is, some moms-to-be experience a considerable energy boost during the second trimester, when nausea starts to wane.

Why am I so tired?

It’s hard work making a baby. The process of supporting the new life inside you taxes every system in your body. The ensuing fatigue is often particularly strong during the first trimester, when you’re building the placenta that feeds and nourishes your baby until birth. Also, the additional hormones circulating during pregnancy — particularly progesterone — can make you feel sleepy and less energetic. Your metabolism is affected as well. Many women have low blood pressure while pregnant because their blood is circulating through two systems — mom’s and the baby’s — and that can cause fatigue.

Will I be feel this way during the entire pregnancy?

Most pregnant women notice that the feeling of exhaustion is stronger at some times than at others. It can also depend on what else is going on in your life, like whether you work a long day or do something physically taxing. The combination of that, plus the demands of pregnancy, can definitely be overwhelming. A few weeks into the second trimester, you may feel a new surge of energy. This often lasts well into the third trimester, but around the seventh month, you may begin to feel weary again. By that point, your increased size and weight will begin taxing your muscles, and you may also have difficulty sleeping, which can leave you tired.

What can I do to ward off exhaustion?

  • Adjust your schedule. Whatever you can do to make sleep a priority will help. Go to bed earlier, even if it means leaving the dinner dishes in the sink until the next day. If possible, work from home once in a while so you can sleep in a little later, or take work home so you can leave work earlier.
  • Try to do the more difficult tasks when you have the most energy, and leave the easier tasks for when you’re tired. Give yourself more time to do things, and try to cut down on multi-tasking, or you may find yourself frustrated.
  • Don’t be shy about asking for help. If your partner offers to take your toddler to school so you can sleep in an extra 20 minutes, take advantage of the offer.
  • Get extra rest. Even if you weren’t a napper before, chances are you’ll become one while pregnant. Catch a catnap whenever possible, and remember that you don’t have to sleep to rest. Many moms-to-be find that lying down as soon as they get home from work makes a huge difference. Stretch out on the couch for 20 minutes when you first walk in the door, and you’ll find you have more energy for dinner and your evening plans.
  • Eat well for energy. What you eat can make a huge difference in how you feel. Relying on carbohydrates and snack foods can lead to quick bursts of energy followed by crashes. Unless you started out obese and are already overeating, you need at least 300 extra calories a day now that you’re pregnant, and more if you exercise. Make them count.
  • Discuss weight with your doctor. Weight gain during pregnancy varies from person to person. You should discuss with your doctor what kind of diet will be healthiest for you. Unless you are underweight or having more than one baby, you don’t want to gain 40 or 50 pounds!
  • Make sleep count. The quality of your sleep can affect how rested you feel. You may be sleeping more lightly now that you’re pregnant, so noises, lights, and other disturbances may bother you. Hang special shades to darken the room, wear earplugs, or use a comfort pillow to ease your back — whatever seems to make your sleep more restful. If you are plagued by insomnia, make a list of what’s bothering you or read for a few minutes, then try again to sleep. After all, soon enough you’ll be awakened every few hours, so this is just your body’s way of helping you get used to it!
  • Protect your time, especially nights and weekends. If going out tires you, spend your nights at home relaxing. But if you feel great, it’s okay to enjoy some nights on the town (just avoid drinking and smoking).
  • Work in some daily exercise. Exercising for at least 30 minutes a day can help boost your energy level and keep your muscles limber during pregnancy. Even taking a short walk or doing some stretches during the day will help you sleep better at night, experts say. Exercising also releases tension, eases back and joint pain, and gets your heart rate up. All these things will also help you sleep.

Talk with your doctor about what kind of exercise program is safest for you. It’s usually not a good idea to begin a vigorous exercise program during pregnancy, especially if you weren’t very active before. On the other hand, some form of daily physical activity, such as walking or swimming, is almost always healthy for pregnant women.

Mayo Clinic. Working during your pregnancy: Tips for the mom-to-be. http://www.mayoclinic.com/

Loyola University Health System. The Second Trimester: 13-28 Weeks. http://www.luhs.org/health/topics/pregnant/second.htm

March of Dimes. Fatigue. 2010.

American Pregnancy Association. Pregnancy and Dizziness. http://www.americanpregnancy.org/pregnancyhealth/dizziness.html

Mayo Clinic. Symptoms of pregnancy: Morning sickness, fatigue and other common symptoms. Updated Feb. 21, 2009

Swedish Medical Center. Exercise and Pregnancy: A Healthy Combination. http://www.swedish.org/19200.cfm

Merck Manual. Diets. http://www.merck.com/

of Dimes. Obesity During Pregnancy Threatens Health of Both Mother and Fetus. 2010. http://www.marchofdimes.com/

American Academy of Sleep Medicine. Sleep Deprivation Takes a Toll: Only 4-6 Hours is Not Enough. http://www.sleepeducation.com/

National Women’s Health Resource Center. Sleep Disorders: Lifestyle Tips. http://www.healthywomen.org/

5 Most Common Second Trimester Symptoms

1. Quickening

You will feel your baby move! At this stage it is called “quickening” and feels like tiny little flutters. It is not an all-out soccer kick that knocks the wind out of you, or one that you can see punching through your belly-that comes in the third trimester; it is a rather soft feeling of bubbles or wispy butterflies in your belly. It is a sweet movement and such an exciting one! These flutters can be felt as early as 13-16 weeks; for the first time pregnancy you are most likely to feel it around the 20 week mark.

2. Hiccups

This is another really fun symptom that comes in the second trimester and is very common. You can actually feel your baby getting the hiccups. At first, this feeling is hard to distinguish from the flutters mentioned above, and it can even be confused for gas (something you’ll get your fair share of during pregnancy as well). Once you figure it out, however, there’s no mistaking it. When your baby gets the hiccups, there is a pattern to the movement that you feel. You can almost time it down to the second and predict when the next one will come.

3. Shortness of Breath

This one is inevitable. Your baby is growing and starting to make less and less room in your body for all of your other organs- including your lungs. While you will have the most energy in the second trimester as your body starts to get used to your new baby, you will still have moments where you are tired and short of breath. Something as simple as walking up a flight of stairs can get you quite winded. This is a normal symptom, however, if you are feeling at all concerned put a call into your doctor. Most doctors are glad to take the after-hours phone call to ease a pregnant woman’s mind.

4. Baby Bump

Finally, it is here! If you are anything like me, you thought you were showing off an early baby bump in the first trimester. Nope! Once the real thing comes along, there is no mistaking it. You probably did have a newly shaped belly in that first trimester, but it was most likely just bloat. Yep, good old fashioned gas, although I still called it my baby bump, because the baby was the cause! The baby bump that you get in the second trimester, however, is that hard baby bump you’ve always seen. A stranger might not be 100% sure if you are carrying yet, but your friends and family will be able to spot that bump a mile away. Wear it proudly, Mama!

5. Heartburn

Heartburn is a very common symptom that can start in the second trimester. During pregnancy, elevated progesterone levels cause your muscles, ligaments, and joints to loosen and relax. This is why your feet grow and your hips widen. The muscle at the bottom of your esophagus that usually keeps food and acid in your stomach also relaxes, however. This results in painful heartburn at times. Consult your doctor to see what medication you can take.

*This post is sponsored by vitaMedMD, a division of TherapeuticsMD. I received compensation in exchange for writing this article. Although this post is sponsored, all opinions are my own and I do not have any relationship to the companies or brands I suggest.

I’m four months pregnant and struggling with stress at work. What can I do?

Talk to your line manager about this. Be realistic about what your priorities are and learn to say no at work if you’re being asked to do too much. Make sure you take regular breaks and cut down on household chores when you’re at home.

Take time out from your anxieties to relax by practising deep breathing exercises, stretching or yoga. Reading a book, having a nap or going for a walk will all help to lower your stress levels. Also, stick to a healthy diet and try to avoid comfort eating.

Your partner may also be feeling anxious and worried about becoming a parent, so try talking together calmly about the issues you have. You can also see your doctor to discuss whether treatment would help.

Find out more about your mental wellbeing in pregnancy.

Is my bump big enough?

During the third trimester your bump will begin to appear. For a while it will look like you have just put on weight, but in the late second trimester it will become rounder and strangers will begin to be able to tell that you are pregnant.

Your bump is measured by your midwife at appointments from 25 weeks (if it’s your first baby) to tell if your baby is growing at a normal rate. They measure from your pelvic bone to the top of your bump. The top of your womb is called the fundus and this measurement is called the fundal height. The measurement should be around the same as the number of weeks pregnant you are (give or take 2cm). So if you are 25 weeks, the measurement should be 23-27cm. it also depends on what is normal for you though. The overall pattern is more important than the isolated measurements and you may be given a personalised growth chart.

If your bump is measuring bigger or smaller than expected your midwife will refer you for a scan and review at the maternity unit.

Read more about measuring the growth of your baby during pregnancy

All the things that made me feel pregnant have stopped and it’s making me anxious

In the second trimester many of your pregnancy symptoms will often disappear or reduce. Your breasts may not feel so tender, nausea or sickness will often stop and the deep tiredness of the first trimester usually goes away, leaving you with more energy than you had before. For some people however, the symptoms of pregnancy, even if they are unpleasant are a reassuring reminder that you are pregnant, and the loss of physical pregnancy feelings brings some worries.

Try instead to enjoy this time, you are not too far away from the third trimester when you will get slower and your bump grows to a size that makes sleeping uncomfortable. Continue being active and eating well, spend time with loved ones, and above all, enjoy your sleep, as it will soon be in short supply

My pelvis has started hurting

Pelvic pain in pregnancy could be a sign of Symphysis Pubis Dysfunction (SPD/PGP), which often starts in the middle of pregnancy. It can cause pain or discomfort that can range from manageable to serious. It is thought to be caused by the hormone relaxin, which loosens the joints in pregnancy to allow your womb to stretch for your growing baby. When you have SPD your joints loosen too much and your pelvis goes out of line.

Read more about pelvic pain and how to manage it here.

I don’t smoke but my partner does. Should I tell him not to smoke in the house?

Other people’s smoke is a health hazard for you and your baby, before and after the birth. Because of this, it’s important to be very firm about insisting that your partner doesn’t smoke in the house or anywhere around you.

Explain that women who breathe in secondhand smoke are at risk of having a low birth-weight baby. Secondhand smoke also puts your baby at greater risk of birth defects and stillbirth.

Keeping your home free from smoke is important after the birth, to protect your baby from chest infections, cot death, glue ear and asthma. Do everything you can to make sure your new baby is not exposed to smoke. If your partner is finding it hard to quit, suggest they use nicotine gum or patches instead when they’re at home.

Find out more about the risks of smoking in pregnancy.

Is it safe to use complementary remedies during pregnancy?

Not all alternative or complementary remedies are safe for you to take now you’re pregnant. There is less information about these types of treatment than there is about conventional medicine in terms of how safe they are and how they work in pregnancy.

If you do decide to go ahead, always go to a qualified practitioner who is registered with their relevant organisation, as they will be trained to advise you on what’s best to use during your pregnancy. You can find a qualified practitioner in your area through the Institute for Complementary and Natural Medicine (ICNM).

Fatigue in the Second Trimester

Every pregnant woman is different, and every pregnant woman’s symptoms are different. So that means the debilitating fatigue that stopped plaguing your best friend in week 11 could certainly keep hitting you well into your third month. That said, there are a couple of things you should keep in mind.

First of all, it’s more typical for exhaustion to start easing up at the end of the fourth month — not necessarily when the first trimester’s over, but when the placenta is fully manufactured.

Second, you might want to consider a few factors:

  • Are you eating enough? As your baby gets bigger and hungrier, your food intake needs to increase as well. The best thing to do is try the six-meal-a-day pregnancy diet solution — grazing on small meals and healthy snacks, which will keep your blood sugar levels up and your energy levels high. Skip sugar and caffeine, which can pick you up briefly only to send you crashing soon after. You’ll get a longer-lasting lift from foods with protein, iron and whole grains — think red meat, poultry, seafood, leafy greens, iron-fortified whole grain cereal and beans.
  • Are you sleeping enough? Make sure you’re getting enough — but not too much — rest. Most women need at least seven hours of shut-eye a night. It’s best to judge if you’re getting the right amount not by the number of hours you’re in bed but by how you feel during the day. If you need more rest, don’t feel guilty allowing yourself the time (you are building another human, after all!). And keep in mind that, paradoxically, getting too much sleep can also be exhausting.
  • Are getting enough exercise? As long as your practitioner has okayed it, you’ll get an energy boost from regular exercise during pregnancy. Keep in mind that it doesn’t have to mean an hour at the gym — even a brisk walk around the block will pick you up.

Tips on How to Cure Insomnia

More About Pregnancy Symptoms

Your Health Heightened Sense of Smell During Pregnancy Your Health “Pregnancy Brain” or Forgetfulness During Pregnancy Your Health Dizziness During Pregnancy Your Health Heightened Sense of Smell During Pregnancy Your Health “Pregnancy Brain” or Forgetfulness During Pregnancy Your Health Dizziness During Pregnancy Pregnancy Insomnia Solutions

In any case, it’s probably a good idea to mention your fatigue to your practitioner. While unlikely, it’s possible that you’re tired because you’re anemic, in which case a little extra iron will pick you up fast.

Good luck,

Tiredness (natural remedies)

Why am I so tired now that I’m pregnant?

It’s completely normal to feel tired during pregnancy. Your body is working hard to grow your baby.
Weariness and exhaustion are very common in pregnancy, especially in the first few months, as your body adjusts to rapidly changing levels of hormones.

In your second trimester you may feel less tired. Although, if you’re working or have a busy family life, you’ll have a lot on your plate and will feel tired as a result.
As you approach your due date, the tiredness will probably return, because your increased weight places extra strain on your body.
You may not be sleeping well at night, especially as your bump grows. Heartburn, thinking about the birth, or needing to get up for the loo are just some reasons why rest may not come easily. You may also be finding it hard to sleep on your side, but it’s well worth persevering. By the third trimester, it reduces the risk of stillbirth (Gordon et al 2015, Heazell et al 2017, McGowan et al 2017, Stacey et al 2011).
If you are expecting twins, have had several pregnancies in quick succession, or have any pregnancy complications, particularly anaemia, you are likely to feel even more tired.

How can I prevent and reduce tiredness?

If you’re often tired, it follows that you should try to rest when you can. If you are at home with small children, put your feet up while they have a nap during the day.
Surprisingly, though, keeping active can help you to fend off fatigue. At work, move away from your desk at lunchtime, have something to eat and drink and get some fresh air. Getting fresh air and exercise during the day will help you to feel more awake.
You could sign up for pregnancy exercise classes such as Pilates or yoga (Alraek et al 2011). These classes help to build your strength and tone your muscles, giving you more energy (NHS Choices 2015a).
Healthy eating will help you to combat tiredness, though this may not be easy in the first trimester, if you have pregnancy sickness. Just nibble what you can to keep your energy levels up.
If you can manage full meals, make sure each one includes:

  • fruits and vegetables
  • a starchy wholegrain, such as pasta, rice or bread
  • a type of protein, such as red meat, fish, egg or pulses
  • low-fat dairy produce

This balance of foods will provide your body with the nutrients that you and your baby need.
Drink plenty of water so you stay hydrated. Not taking in enough fluid can add to your tiredness and give you headaches.
Try to keep your blood sugar reasonably even to avoid getting low blood sugar (hypoglycaemia), which may make you feel drained. You can do this by eating small meals, often. Try not to skip any meals, especially breakfast. Keep a snack with you, such as a banana or some savoury crackers, so that when you start to feel tired, you can top up your blood sugar.
Eat foods that are high in iron to prevent anaemia. Being short of iron will add to any tiredness you are already feeling. Dark green vegetables, a small amount of lean red meat, and dried apricots are good sources of iron.

Which complementary therapies may help with tiredness?

Many complementary therapies promote relaxation, and help to restore energy levels. Always see a registered practitioner who’s qualified to treat pregnant women.
Acupuncture
Acupuncture stimulates the release of feel-good chemicals (endorphins) in your brain (Li and Longhurst 2010, NHS Choices 2015b). This may help to address excessive tiredness.
Aromatherapy
Enjoy a relaxing bath with a maximum of three drops of aromatherapy essential oils such as lavender, grapefruit or bergamot.
Lavender oil is safe in pregnancy if you use no more than three drops at a time, but don’t use it every night (Tiran 2014).
Aromatherapy massage is a relaxing option. You can either see a qualified therapist, or ask your partner to give you a massage before bed, which may help you to sleep better. A drop of essential oil, mixed with a teaspoon of base oil such as grapeseed, is ideal for massage.
Bach Flower Remedies
Bach Flower Remedies such as olive and hornbeam may help you to cope with your tiredness. Although there’s no good evidence that Bach Flower Remedies are effective (Thaler 2009), many women find them helpful.
Bach Flower Remedies come in a solution of brandy to preserve them. If you don’t want to consume even a few drops of alcohol during pregnancy, they may not be for you.
If you are exhausted and feeling stressed, talk to your midwife or doctor. They are there to support you emotionally as well as physically throughout your pregnancy.
Unfortunately, tiredness is just one common pregnancy side effect. Learn what else to expect in our video, where new mums reveal how their bodies changed during pregnancy.
Alraek T, Lee MS, Choi TY, et al. 2011. Complementary and alternative medicine for patients with chronic fatigue syndrome: A systematic review. BMC Complement Altern Med. 11: 87
Gordon A, Raynes-Greenow C, Bond D, et al. 2015. Sleep position, fetal growth restriction, and late-pregnancy stillbirth. Obstet Gynecol 125(2):347-55
Heazell A, Li M, Budd J et al. 2017. Going-to-sleep supine is a modifiable risk factor for late stillbirth – findings from the Midlands and North of England Stillbirth Case-Control Study. BJOG online first: 20 Nov. onlinelibrary.wiley.com
Li P, Longhurst JC. 2010. Neural mechanism of electroacupuncture’s hypotensive effects. Auton Neurosci. 28; 157(1-2): 24-30
McGowan LME, Thompson JMD, Cronin RS, et al. 2017. Going to sleep in the supine position is a modifiable risk factor for late pregnancy stillbirth; Findings from the New Zealand multicentre stillbirth case-control study. PloS ONE 12(6):e0179396. journals.plos.org
NHS Choices. 2015a. Tiredness in pregnancy. NHS Choices. Health A-Z. Pregnancy and baby. www.nhs.uk
NHS Choices. 2015b. Acupuncture – evidence, clinical trials. NHS Choices, Health A-Z
Stacey T, Thompson JMD, Mitchell EA, et al. 2011. Association between maternal sleep practices and risk of late stillbirth: a case-control study. BMJ 342:d3403. www.bmj.com
Thaler K, Kaminski A, Chapman A, et al. 2009. Bach Flower Remedies for psychological problems and pain: a systematic review. BMC: Complementary and alternative medicine. www.biomedcentral.com
Tiran D. 2014. Aromatherapy in Midwifery Practice, a manula for clinical practice. 4TH edition. Expectancy: London

Is it unusual for the extreme fatigue of the first trimester to continue into the second trimester? Shouldn’t it be gone by now?

Let’s face it — being pregnant is no walk in the park (and sometimes, it can even make that walk in the park feel like a marathon run). It’s hard work, and lots of it. That said, most pregnant bodies start to adjust to the physical, emotional, and hormonal demands of pregnancy by the time they’ve finished their fourth month — a month into the second trimester, and just about when the placenta is fully manufactured (whew!). If you’ve already entered your fifth month and your energy level still hasn’t started picking up, it could just be that your pregnancy is a particularly draining one (remember, every pregnancy is different). It’s also possible that the get up and go you’re hoping for may be just around the corner…then again, it might not be in the pregnancy cards for you. Or, there might be an explanation for your energy deficit. Ask yourself: Are you getting enough nourishment, and getting it regularly enough? As your baby gets bigger and hungrier, your food intake needs to keep up with demand. Grazing on small, frequent meals and healthy snacks will keep your blood-sugar levels up and your energy level high (not to mention, head off those headaches). Put down that chocolate bar and Coke (as well as other sources of sugar and caffeine, which will lift you up briefly, only to send you crashing soon after), and pick up a combo of complex carbs and protein instead (it’ll give you the sustained energy bang you’re banking on). Also make sure you’re getting enough rest — but not too much. Paradoxically, too much sleep can be exhausting. Another paradox: Exercise (yes, the exercise you may have been avoiding because, well, you’re too tired) is energizing. As long as your practitioner has given you the workout green light, you’ll get an energy boost from regular exercise (even that walk in the park will pick you up) — again, as long as you don’t overdo a good thing (stop before you’re beat). Yet another possible trigger of second-trimester fatigue: iron-deficiency anemia (your iron intake has to keep pace with a rapidly growing blood supply). But that diagnosis will take a little investigation (and a little blood test), so check with your practitioner. If your levels do turn out to be low, some extra iron will pick you up fast.

Wishing you a less-tired tomorrow,

Being pregnant can be a tiring experience for a woman’s body. Both the physical discomforts of pregnancy as well as the emotional stress of this major life change can cause sleep problems and keep a mother-to-be awake at night.

People may joke that the difficulty many pregnant women have sleeping is merely preparing them for the lack of sleep they will experience when the baby finally arrives. All kidding aside, pregnancy is a good time for women to take their sleep needs more seriously and make an effort to get more of it.

Feeling exhausted is a common complaint, especially during the first and third trimesters. But women might be caught off guard by how worn out they feel in the early months of pregnancy.

“A lot of women are totally surprised by how fatigued they feel during the first trimester,” said Kathy Lee, a professor of nursing at the University of California San Francisco, who has studied how pregnancy affects sleep.

Women know about morning sickness in early pregnancy, but many first-time mothers say they had no idea about how tired they often feel at this stage, Lee said.

Sleeping for two

Similar to the advice that a pregnant woman should be “eating for two,” health professionals should also be emphasizing the importance of “sleeping for two” during prenatal visits, Lee told Live Science.

One reason is that pregnancy can affect both the quantity of sleep a woman gets as well as the quality of it.

As their body changes and pregnancy discomforts make it more difficult to fall and stay asleep, Lee recommended that mothers-to-be spend at least 8 hours in bed each night so they can get at least 7 hours of sleep.

Researchers have found that not getting enough sleep during pregnancy could affect a woman in ways that go beyond feeling exhausted during the day, being irritable and having poor concentration.

One of Lee’s studies found that first-time mothers who got less than 6 hours of sleep at night were 4.5 times more likely to have a C-section and their average length of labor was 10 hours or longer compared with first-time mothers who slept 7 hours or more.

“A woman really needs to go to bed earlier when she is pregnant,” Lee said. Women need the extra rest, and they can’t keep going on the same amount of sleep they got before becoming pregnant, she pointed out.

Pregnancy and fatigue

Researchers are still trying to figure out the exact reasons why pregnancy causes a woman to feel so exhausted, Lee said.

But to some extent, pregnancy-related fatigue is hormonal, she said. In the early phases of pregnancy, progesterone levels start to increase.

“Progesterone is a hormone that slows a woman down and mellows her out, and some women may perceive these effects as fatigue,” Lee said.

Besides the influence of hormones, some of the sleepiness that women feel early in pregnancy could also be physiological as the uterus gets bigger and the fetus grows, coupled with pregnancy-related weight gain and fluid accumulation in the body, Lee said. These changes mean the body is working harder as the placenta forms to nourish the developing fetus, the blood supply increases and the heart beats faster.

And emotional factors can also play a role. The excitement and anticipation of having a baby as well as the fears of impending motherhood and the anxiety about labor and delivery can all be stressful and make a woman feel more tired than usual.

Here’s what to expect in terms of sleep changes during the three stages of pregnancy.

Sleep and the first trimester

In the early months of pregnancy, rising progesterone levels may not only make a woman feel drowsy, but they may also be partly to blame for the frequent need to pee, which can also disrupt sleep and worsen sleepiness.

During the first trimester, the hormones leading to the bladder get sluggish, which increases a woman’s urine production. This can cause her to wake up and need to go to the bathroom more frequently at night, Lee explained.

To reduce their nightly bathroom visits, women who are expecting should not cut back on drinking plenty of fluids during the day because water and other liquids are important to help prevent constipation and excessive swelling, two common pregnancy discomforts. But they might cut back on fluids in the evenings.

During those nightly bathroom trips, women should rely on a nightlight rather than turning on a bright bathroom light, which could make it harder to fall back to sleep.

Another factor that can rob a woman of the shuteye she needs is the nausea known as morning sickness, which can happen any time of the day or night. To relieve the queasiness, some women eat crackers or dry cereal before getting out of bed in the morning.

A woman’s breasts may also feel more sore and tender during pregnancy, making it challenging or uncomfortable to sleep on her stomach, if that’s her preferred position.

Women might also feel warm or hot when they sleep during pregnancy because of an increased metabolic rate, Lee said. A fan is often nice to keep a woman cooler, she said, plus it has the added benefit of blocking out noise inside and outside the bedroom, including a snoring bed partner.

However, bed mates are not the only ones who might be snoring. Snoring is a common occurrence during pregnancy, and it can start in the first trimester in women who are already overweight or have allergies, Lee said.

Because of the many possible disruptions to sleep during pregnancy, napping is a good idea as long as a woman can fall asleep at night, Lee said.

But avoid using sleeping pills or even sleep-inducing supplements, such as melatonin, during pregnancy, Lee said. “Most women are too afraid to take them,” she added.

Sleep and the second trimester

The second trimester of pregnancy is usually the best for women, Lee said. “Everything levels out and things aren’t changing quite as fast.”

Lee explained that hormonal changes, which are steep during the first trimester, level off during the second trimester, and then are steep again in the third trimester.

Leg cramps might occur at night during the second trimester. And some pregnant women, especially if they anemic and have low iron levels, may experience restless legs syndrome beginning in the evening hours of the second trimester and becoming more severe in the third trimester, Lee said. This condition, in which the the legs feel jumpy like they have ants crawling up and down their veins, can occur while sitting or lying down and might be extremely uncomfortable.

Often the only relief from the pain is from walking around, Lee said, but then a woman might not be able to fall back asleep.

Heartburn is another problem that can keep women awake at night. As pregnancy progresses and a woman’s uterus gets bigger, it may press on her stomach making a burning sensation more common.

Sleeping on the left side with the knees bent may be a better position for women who are experiencing heartburn during pregnancy, Lee said. Some women may also try sleeping with the head of their bed elevated or by propping their head on more pillows to ease the acid backwash of heartburn.

A lot of women say they have bizarre dreams related to their baby during pregnancy, Lee said. Although many women report strange dreams, the results from her research did not show any differences in dreaming across the trimesters compared with dreaming before a woman becomes pregnant.

“It might be that women are able to remember their dreams better during pregnancy because they are waking up more often,” Lee told Live Science.

Sleep and the third trimester

One study suggests that in late pregnancy, women report that the overall quality of their sleep suffers, they have more trouble falling asleep, and their number of nighttime and early morning awakenings increase compared with mid-pregnancy.

As a woman’s belly increases in size and the fetus is getting bigger and more active, Lee suggested that pregnant women sleep in any comfortable position they can find.

But she advised mothers-to-be to stay off their backs as much as possible because a heavy uterus can press on nerves in the spine and on a major vein (the inferior vena cava) that carries blood between the lower body and heart.

The National Sleep Foundation recommends that pregnant women should sleep on their left side, which may improve the flow of blood and nutrients to the developing fetus and to a woman’s heart, uterus and kidneys.

Use pillows to be more comfortable placing one between the knees, a second under the belly, and a third behind the back to support it and relieve pain, Lee advised.

Snoring is also a more common occurrence in the third trimester of pregnancy as a result of weight gain and more nasal congestion, Lee said. She recommended that women who have stuffy noses use nasal strips to help open up their nasal passages and improve their night-time breathing.

One study found that women who began snoring while pregnant may be at greater risk of pregnancy-related high blood pressure and preeclampsia, a condition of high blood pressure during pregnancy, compared with mothers-to-be who did not snore.

Additional resources

  • March of Dimes: Sleeping Problems
  • AJOG: Sleep in late pregnancy predicts length of labor and type of delivery
  • NIH: Bed Rest During Pregnancy

Second Trimester of Pregnancy

You made it through the first trimester! For most people, this means you should see an end to the extreme fatigue and morning sickness that made those first weeks tough.

During this next trimester, you’ll probably feel more energetic—take advantage of this to start nesting. You’ll definitely begin to look pregnant during your second trimester (hello, belly!), so now’s the time to build out your maternity clothing wardrobe. Your baby will also be very busy developing, putting on the pounds and starting to move around in there.

Here’s what to expect during your second trimester.

Second Trimester Weeks

Weeks 13-27

Baby’s development in the second trimester

Baby is kicking it into high development gear now. A lot happens during the second trimester.

Baby starts the second trimester around 2.9” and 0.81 ounce (around the size of a Tamagotchi virtual pet. By 27 weeks, they’re about 14.4” and 1.93 pounds. Go, baby, go!

They’ll begin to be measured in something called fundal height, which is basically the size of your bump, or the distance from your pubic bone to the top of your belly. This measurement is used as a way to make sure baby is growing.

What else is going on there? By 16 weeks, their umbilical cord is fully developed, and by 18 weeks, baby can hear—your heartbeat is the loudest sound they hear. By 25 weeks, they’ll be responding your voice—and by end of the second trimester, your partner’s. Time to talk to baby and make them a playlist of all your favorite songs!

By 18 weeks, baby can hear—your heartbeat is the loudest sound they hear.

Baby is growing a softy coating called vernix caseosa, or “cheesy varnish” that prevents their skin getting all wrinkly in the amniotic fluid. It will mostly slough off by birth, but you might notice some if it still on baby’s skin after their born. Same for lanugo, which is the soft, fine hair that covers a newborn.

If you want to find out your baby’s sex, you’ll be able to at your 20 week ultrasound (assuming baby cooperates!).

They’re also developing something called meconium, which will become baby’s first poops. Most babies pass this shortly after birth (though some do it in utero or on the way out). These poops look gross and are sticky, but they don’t smell and are usually gone with the first day or two, replaced by other gross poops that come with breastfeeding or formula feeding.

By the end of the second trimester, baby will have developed regular sleep patterns, which usually means they’re lulled to sleep during the day by your regular movements and up and ready to party when you’re turning in for the night. Also, hiccups, which you’ll feel. So cute!

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Second trimester pregnancy symptoms

Heartburn during pregnancy

The good news is that the nausea of your first trimester has probably passed. The bad news? Up to 50 percent of women experience heartburn at some point during pregnancy, thanks to increased progesterone levels relaxing the tube between your stomach and esophagus, allowing stomach acid to pass more easily into the esophagus.

If you’re suffering, here are some ways to relieve the discomfort

  • Avoid spicy or fatty foods, or other types of food and drinks that don’t agree with you. It could be anything from caffeine to citrus fruits.
  • Eat smaller meals throughout the day instead of three big ones.
  • Don’t eat right before bedtime. Give your body at least an hour to digest before hitting the pillow.
  • Talk to your doctor. If your heartburn is severe or doesn’t seem to be improving with lifestyle changes, there are prescription meds that could help. Avoid taking an over-the-counter antacid, though, without talk to your healthcare provider.

What to eat—and what to avoid—during pregnancy

Now that your appetite is—hopefully—back, you’ll want to make sure you’re eating healthy and getting the good nutrients you and your baby need. Now is not the time to count calories, but it is a good idea to be mindful about eating a well-balanced diet with lots of whole grains, fresh fruits and veggies, lean proteins and good-for-you fats, like avocado.

In general, pregnant people should eat somewhere between 2,200 and 2,900 high-quality calories a day. You should aim for an additional 340 more calories than normal during your second trimester.

Now is not the time to count calories, but it is a good idea to be mindful about eating a well-balanced diet.

Try to increase your intake of calcium (think yogurt and dark, leafy greens like kale and spinach) and iron (beans, tofu and nuts like walnuts and almonds are good non-meat options), as well.

There are some foods that are good to avoid during your pregnancy. Opinions vary on the safety of certain things—some steer clear of caffeine, for instance; others embrace their morning latte—but in general, it’s a good idea to avoid fish containing high levels of mercury, like tuna, shark and other big fish, as well as foods like raw, soft cheeses, deli meats and hot dogs, because of the risk of listeria. It’s a food-borne illness that you’re at a greater risk of getting when you’re pregnant.

As for alcohol, most doctors and midwives would say avoid it completely, though there aren’t any studies that say an occasional glass of wine (actually one glass, like 4 oz) has negative effects on babies later in pregnancy.

Feeling your baby move

Between 18 and 25 weeks, you’ll probably begin to feel your baby moving. So exciting! At first it feels like a light fluttering, known as “the quickening,” but you’ll soon start feeling kicks, jabs and somersaults from your growing baby. As you get later in your second trimester, your partner may be began to feel baby moving around in there, too. At the beginning of your third trimester, you’ll start doing kick counts.

Leg cramps during pregnancy

You may start experiencing leg cramps during your second trimester, particularly when you’re sleeping, thanks to pregnancy weight gain, swelling and changes to your circulation that make it hard for your blood to get from your legs to your heart.

While they are super annoying and disrupt your sleep, leg cramps aren’t serious. If you’re experiencing them, drinking water, stretching throughout the day and regular exercise can help you prevent them. Compression socks or stockings can also help get your blood flowing, particularly if you’re flying.

When leg cramps do wake you up at night, stretching and massaging the muscle, as well as applying a well warm washcloth or heating pad, can help ease the cramping.

Second Trimester Baby Bumps

Sleep during your second trimester

The exhaustion of your first trimester should be gone, but as you move toward the latter part of your second trimester, you’ll find yourself faced with new sleep challenges.

As your belly grows and your body changes, you may find it harder to get comfortable at night. Pregnancy pillows will be your friend. Consider shopping for one now.

This also is a good time to start sleeping your side, particularly your left, as it’s the best position for blood flow to the uterus. Of course, you can’t stay in one position all night, so if you wake up on your back, don’t freak out! Just roll over and try to go back to sleep.

Sex during pregnancy

You may find yourself wanting sex more often during your second trimester—your morning sickness is gone, and all that estrogen may be kicking your desire into high gear. Or not. If you’re just not feeling it, know you’re not alone. Be open and honest with your partner, and find other forms of intimacy to foster your connection. (Here’s a NSFW podcast with tips for parent sex).

You may find yourself wanting sex more often during your second trimester.

If you are comfortable having sex, don’t worry about hurting the baby—they’re nice and cushioned in all that amniotic fluid—and experiment with positions that are comfortable for your changing body. Also, as long as your doctor says it’s okay, you can keep doing it until you go into labor.

Stretch marks and other pregnancy skin issues

Your skin goes through lots of changes during your pregnancy. As your belly expands during your second trimester, you might notice stretch marks developing on your stomach (they also sometimes show up on your butt, thighs, hips and breasts). They start out pronounced, ranging from dark brown to pink, depending on your skin color, and eventually fade, though they never really go away. Not all women get them, and you can’t really do anything to prevent them from happening. You’ll see a lot of stretch marks creams on the market, but they haven’t been proven to do anything to reduce them or stop them in the first place.

Creams and lotions can help relieve another pregnancy skin issue some women experience—an itchy, dry belly. Fragrance-free versions are your best bet, so they don’t further irritate your skin.

You may also notice blotches of darker skin appearing on your face (known as “the mask of pregnancy”) or a dark line—linea nigra—appearing from your pubic bone and up and over your belly button. The official name for it is melasma, and it’s from an increased production of melanin. If it’s affecting you, try wearing sunscreen (SPF 30 or higher) every day and wear a hat when you’re outdoors. This should go away on its own once your baby is born.

Weight gain in the second trimester

Most people have gained about eight to 10 pounds by midway through their pregnancy (around 20 weeks), and will start gaining a half to a full pound per week going forward. By the end of the second trimester, you’ll probably have gained 12-17 pounds.

About one-quarter of your weight gain is coming from extra fluids (here’s what makes up the rest), so swelling during pregnancy is completely normal, especially in your ankles and feet. If it gets uncomfortable, try staying off your feet and reducing your caffeine and sodium intake to manage it. If you have sudden, extreme swelling in your hands and feet, contact your doctor. It may be a sign of preeclampsia.

What is preeclampsia?

Some pregnancy complications can be scary. Preeclampsia is one of them. A condition that involves high blood pressure and damage to the kidneys or liver, it affects between two and five percent of pregnancies. It usually begins after 20 weeks of pregnancy.

What are preeclamsia symptoms?

  • Blood pressure above 140/90 on two occasions and blood pressure above 160/110 at least once
  • Upper abdominal pain
  • Protein in the urine
  • Swelling in the face or hands (not everyone experiences swelling)
  • Vision changes, like blurry vision or seeing spots
  • Headaches that don’t go away
  • Vomiting (in the second half of pregnancy)

If you notice any of these symptoms, call your doctor as soon as possible. Know that preeclampsia is treatable, so getting the right care early enough is very, very important for you and baby.

Second Trimester Pregnancy Checklist

  • Schedule your 20 week ultrasound (and decide if you want to find out your baby’s gender).
  • Make your pregnancy announcement to friends and family.
  • Start your baby registry.
  • Make your list of baby names.
  • Schedule a dental cleaning. Pregnancy increases the risk of gum disease, so take extra care of those teeth right now.
  • Baby shower time is quickly approaching. First steps: figure out who is going to host and where, set a budget and pick a date.
  • Enroll in a childbirth or baby care class through your hospital, birthing center or local parenting center.
  • Make your gestational diabetes lab appointment for 24–28 weeks (remember you have to wait 1-3 hours at the lab).
  • Schedule a few daycare tours if you’ll be needing childcare.
  • See if your health insurance will provide a free breast pump.
  • Decide if you’re going to hire a doula.
  • Write your birth plan.
  • If you’re thinking of taking a babymoon, talk locations and start booking your travel.
  • Make time for yourself. Schedule a prenatal massage, mani/pedi or whatever makes you happy.

Changes in Your Body During Pregnancy: Second Trimester

What other changes can I expect during the second trimester?

Leg pain. You may have leg cramps, especially when you sleep. These may be related to the pressure your growing baby puts on the nerves and blood vessels that go to your legs. Make sure you sleep on your side instead of your back.

Another leg condition, deep vein thrombosis (DVT), can be serious. DVT is a blood clot that forms in a vein, and causes pain and swelling in one leg. Contact your doctor right away if you have these symptoms.

Puffiness. Your ankles, hands, and face may swell during the second trimester. This happens because your body retains more fluid for the baby. You also have slower blood circulation.

Aching back, pelvis, and hips. The job of supporting your growing belly puts stress on your back. Your hips and pelvis may begin to ache as pregnancy hormones relax the ligaments that hold your bones together. Your bones move to prepare for childbirth.

Stomach pain. The muscles and ligaments supporting your uterus stretch as your uterus grows. These can cause mild pain or cramping.

Loose teeth. Pregnancy hormones also affect the ligaments and bones in your mouth, so teeth may loosen. They return to normal after pregnancy. Contact your dentist if you have bleeding or swelling of your gums. These symptoms can be signs of periodontal disease. This condition has been linked to preterm (early) birth and low birth weight. The second trimester is the best time to have dental work done.

Nasal congestion, nosebleeds, and bleeding gums. These result from increased blood flow to the mucous membranes in your nose and mouth.

Heartburn. Heartburn may begin or worsen in the second trimester. Your growing uterus presses on your stomach, which can force food and acid up into your esophagus, causing the burn.

Urinary tract infections (UTIs). You may develop an infection in the second trimester. Hormonal changes slow the flow of urine and your bladder doesn’t empty completely because your enlarged uterus pushes on it. Untreated UTIs can lead to preterm labor, so tell your doctor if you think you have one. Symptoms include needing to urinate more often, a burning sensation when you urinate, or the presence of blood or a strong odor in your urine.

Braxton Hicks contractions. Also called “false labor,” Braxton Hicks contractions are a tightening of your uterine muscles. It’s one of the ways your uterus prepares for labor and delivery. Braxton Hicks make your belly feel very tight and hard, and may cause discomfort. The contractions are irregular in timing and should go away within a few minutes. Call your doctor if they become regular and painful, and don’t go away when you change your position or walk around. It might be preterm labor.

Things to consider

The changes in your body affect other things in the pregnancy process.

When will I feel my baby move?

Near the middle of your second trimester, you may begin to feel the baby. In the beginning, this feels like fluttering movements deep in your belly. Your baby moved before this, but it was too deep for you to fill it. If you have been pregnant before, you might notice the movements earlier because you’re familiar with how they feel. Mark your calendar when you first feel movements so you can let your doctor know.

Will my interest in sex come back?

You may not have felt like having sex during the first trimester. Symptoms such as morning sickness, mood swings, and low energy can affect your interest. Many women find that their desire for sex returns during the second trimester. Having sex is fine anytime during pregnancy, unless your doctor says otherwise.

When to see your doctor

Continue to visit your doctor for ongoing prenatal appointments. Usually, these occur about once a month. Ask them questions about the process and tell them about any concerns you have. Contact them if you have unusual changes or symptoms.

Questions to ask your doctor

  • What kinds of physical and emotional changes should I expect?
  • Are my symptoms normal?
  • Are there any lifestyle changes I can make to ease symptoms?
  • Are there any risks that I should be aware of?
  • Is it safe to have sex?

Resources

American Academy of Family Physicians, Taking Care of You and Your Baby While You’re Pregnant

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